If I order medication for international import, will my package be seized at the border?

Written by Lucia Mueller | Posted March 10, 2023 | Updated March 13, 2023

If you order medication from abroad for personal use, the chances that it will be held at the border are incredibly slim. While the law allows the FDA and U.S. Customs and Border Protection to detain and refuse international prescription orders arriving through the mail, less than one percent of medication orders are actually stopped, at least for orders where a prescription is required and under a 90-day supply. International pharmacies accredited through the PharmacyChecker Verification Program are not permitted to sell medications without first requiring a valid prescription. If your medication is stalled at an international mail facility, you will hear about it! The FDA is required by law to send a letter alerting you that your drug order was detained or refused. You are allowed to contest the FDA’s decision, which we will touch on in the following post.

Why do Americans import their prescription drugs?

Most people in the U.S. who import medication for themselves do so for two reasons: 1) they are frugal consumers and savvy internet users – or 2) they are forced to because they have no other choice. A chronic illness diagnosis is physically taxing enough, but the ripple effect it has on your mental health and finances can be devastating. According to a Kaiser Family Foundation poll, “a quarter of adults say they or family member in their household have not filled a prescription, cut pills in half, or skipped doses of medicine” in 2022 due to cost.

When we shop for anything, it’s worth considering both quality and cost, but both are of chief concern with prescription drugs. They are inextricably linked. At PharmacyChecker, we often compare brand-name drug prices in the U.S. with those available abroad, at international online pharmacies that we verify for safety. The savings can be enormous for what is likely to be the same exact medication you’d get at your local pharmacy or a version of that medication approved for sale in another country: 70-90% off the U.S. retail price.

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I order my dog’s medication from an Indian online pharmacy

This isn’t the most glamorous price savings story, but let me tell you about my experience importing medication from an online pharmacy that works with dispensing pharmacies located in Australia, Canada, India, Mauritius, Turkey, the United Kingdom and the United States. This particular pharmacy ships worldwide and is accredited by the PharmacyChecker Verification Program.

Ketoconazole, the yeast medication my dog must take daily as part of a special cocktail to relieve her itching, is $0.67/pill from an online pharmacy in India (including shipping). That’s $244.55/year compared to the $368.65 annual cost from my local veterinarian’s office – 34% cheaper. Some time last year, fed up with my vet bills, I went to PharmacyChecker.com to compare pricing. I also took a look at Chewy.com and 1800PetMeds.com – just in case a local option was worthwhile. (U.S. prices on generic medications are usually comparable if not cheaper than international mail order pharmacies.) A PharmacyChecker-accredited online pharmacy won out. 

Although my chosen online pharmacy works with several dispensing pharmacies across multiple countries, I learned that my particular medication would be shipped from a dispensing pharmacy located in India. PharmacyChecker ensures not just the safety credentials of the online pharmacies it accredits, but also that of the international dispensing pharmacies. The PharmacyChecker Verification Program includes licensed pharmacists that conduct annual in-person inspections of dispensing pharmacies in India. I had my veterinarian fax me the prescription, which I then uploaded to the online pharmacy’s patient portal once I placed my first order. Thereafter, I have been coordinating with them to refill my pup’s prescription every 90 days so I receive the next batch before we run out. Delivery time is usually 2-3 weeks, which is not a big deal once you get on a schedule. Instead of the bottle of pills to which I'm accustomed here in the U.S., the tablets come in blister packs.

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Is it legal to import my prescription medication?

Despite the FDA saying people are generally not allowed to order or bring prescriptions into the U.S., there are many people that do. In fact, there are slews of programs set up nationwide to help people buy their prescription drugs from abroad. They include private insurers, county governments, school districts, employers, etc. The point is you are neither alone in your quest to afford your medication – nor should you let the sticker shock you may get at a local pharmacy counter preclude you from accessing what you are prescribed. 

The manufacturer on the label of my dog’s ketoconazole is an FDA-approved manufacturer, but the way in which it’s packaged is what may make it technically illegal. Many drugs sold to people, like me, with valid prescriptions via international mail are drugs that are also found in the U.S., the only difference being labeling or packaging. Some – most reliably, brand name medication – are even made in the same manufacturing facilities. The FDA says, despite a shared facility, this difference in labeling and packaging somehow makes the medications more dangerous. It’s frustrating because the majority of medications sold at U.S. pharmacies are produced abroad, but the FDA allows drug companies to import them without batting an eye. The People’s Pharmacy puts the injustice surrounding FDA’s messaging on personal drug importation quite plainly:

“The Food and Drug Administration must think people are stupid. The agency claims that it is dangerous to buy brand name drugs made by major pharmaceutical manufacturers like Pfizer, Merck, AbbVie or Roche if they are imported from Canada. But it is perfectly fine for drug wholesalers and mail-order pharmacies to purchase generic drugs from countries like Slovakia or China.”

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Will my international medication order be seized at the border? 

Millions of Americans, beyond just me ordering my dog's medication, successfully receive their prescriptions via international mail. These drugs and their cost savings are objectively more critical than my dog meds. Indeed, many patients need PharmacyChecker.com to compare prices for their diabetes, asthma, cancer, and HIV medications that come from reliable pharmacies so they don’t get burned by dangerous websites posing as legitimate pharmacies online. Thankfully, like me, they more likely than not receive their medications. As long as you are ordering less than a 90-day supply for personal use, there’s over a 99% chance that your prescription order will arrive safely. As reported in Kaiser Health News“[because] of the sheer volume of mail, even as the FDA has stepped up staffing at the mail facilities in recent years, the agency can physically inspect fewer than 1% of packages presumed to contain drugs, FDA officials said.”

See: Patients and Health Professionals Recommend PharmacyChecker Savings & Safety Information

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What if my medication is seized at the border?

PharmacyChecker rarely encounters a consumer complaint about a seized medication order, but it’s certainly a possibility. According to Prescription Justice, “federal law gives the FDA authority to destroy your personally imported medication, but not without notifying you first, and providing you with appropriate due process and opportunity to obtain your prescription drug order.”

You can respond to FDA notifications to reclaim your import, but, because you won’t be receiving your medication when you had planned, the first thing you should be worried about is adherence to your prescription. Talk to your doctor about getting drug samples, patient assistance programs, coupons, etc., so you can stay on track.

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